The cash-strapped NHS could be spending up to £15 million on management consultants for advice on the secretive shake-up of the health service in England, Unite, the country’s largest union, warned today (Monday 16 January).

Unite, with 100,000 members in the health service, said that health secretary Jeremy Hunt needed ‘to come clean’ on the true cost of the expenditure on management consultants in relation to the 44 Sustainability and Transformation Plans (STPs) for England.

The union said another major reconfiguration of the NHS, following hard on the heels of the controversial Health and Social Care Act 2012, could see closures or relocations of local hospitals and A&E departments.

Unite calculated the £15 million figure, after the media revealed that NHS chiefs in Coventry and Warwickshire had forked out £343,000 to PricewaterhouseCoopers (PwC) for advice on saving money in their local STP plan.

If each of the 44 STPs spent a similar sum on management consultants, the figure could reach £15 million, as the NHS is enveloped in a winter crisis, reinforced by hard-hitting comments last week by the chief executive of NHS England, Simon Stevens on the level of funding the NHS had received from the Tory government.

Unite national officer for health Sarah Carpenter said: “It is very disturbing news from Coventry and Warwickshire that the management consultants are again scooping up loads of taxpayers’ cash to proffer advice on the local STP.

“If this sort of spending was extrapolated across the 44 STPs in England we are talking about a figure of £15 million – Unite is calling on Jeremy Hunt to come clean on how much management consultants are being paid for so-called advice on STPs.

“Any such funds would be much better spent on frontline services, such as under pressure A&E departments, rather than on jargon-filled reports.

“The NHS is reeling from a starvation of cash. The health service is at crisis point and we have not yet reached the worst of the winter weather.

“Simon Stevens, the head of NHS England, is right to raise serious concerns at the insufficient level of NHS funding and an urgent financial injection into the health service is desperately needed.”

The 44 STP ‘footprints’ for the disparate geographical areas each have their own plans, which were prepared by mainly local NHS apparatchiks with no public involvement. The limited public consultation process was due to start this month, with implementation expected later in the year.

0.013% of budget on consultancy fees doesn't seem at all disproportionate?

Value for money? Mmm, tend to agree with granny on this, I've seen PWC operate at first hand. Surely bound to be conflicts of interests where PWC have other clients that will benefit from their NHS recommendations?

In a time of universal deceit - telling the truth is a revolutionary act. George Orwell

When the debate is lost, slander becomes the tool of the loser. Socrates

Sounds a bit like Wirral Councils spending on the Golf Coast consultancy fees. Although in the NHS case its to see if they need to sack anybody whilst in the Golf Coast case its just to realise how bad an idea it was in the first place. (he says rather cynically). No I really do think we need 3 golf courses in Hoylake...one for the upper class, one for the middle class and one for the riff raffs.

I had an aunt who was a hospital matron in the 1940s to 1950s. She ran the place like a dictator. No committees, no consultants, she terrified everyone into obedience, reducing ward sisters and doctors to tears if they transgressed. I was her favourite nephew and she terrified me too. She invited - well ordered - me to her hospital once. When I got there, I asked to see her and was asked why by the nurse who'd seen me wandering in. I explained i was the matron's nephew, and her response was a hertfelt "Oh, you poor thing!"

She, my aunt, had been a nurse in WW1 and knew what infection could do, so absolute hygiene was her obsession. She would run her fingers over the tops of doors or cupboards and if there was a hint of dust, someone would suffer from a tongue lashing from her.

I often wonder what she would have made of the unholy horde of management consultants that infest hospitals these days.

There's a reason there's so many golf courses on Merseyside, that's because they're some of the finest courses in the country.

Just because they're located on your doorstep doesn't mean that they're for locals only. I know plenty of people all across the North who travel to Wirral to play, because they think the courses are exceptional.

And that's why professional tournaments are held here, and bring in money:

Ha ! Isn't that a strange one ? I know a number of people from Wirral, who go to Chester and North Wales to play. Maybe this is the thing to do. Socialise in different areas so no one knows your social History ! Make new business contacts etc.

By the way £76m is only a figure put out by Press and PR dept. and it depends on how they calculate those figures. Most of it would have gone to Liverpool.

Humankind has not woven the web of life. We are but one thread within it. Whatever we do to the web, we do to ourselves. All things are bound together. All things connect. ~Chief Seattle

Hi Gibbo. One of the problems of internet forums is that words don't often convey the sarcasm perhaps intended.

I didn't mention the quality of golf courses or even denigrate the sport. Saturday mornings as a youth were spent playing the 9 holes at Arrow Park. Having hit the kiosk roof off the 9th tee probably made me realise it might not be my sport. Use to play at West Kirby till council sold it to Morrisons Merely questioning the Wirral Councils risky expenditure on feasibility studies. Is it around £1 million pounds so far?I work for council and when you've been called in twice to see if your jobs safe with the £132 million cuts then maybe you can understand why some people question it.Council could have said to a developer we will give you planning permissions etc even though some is greenbelt as long as you do all the feasibility studies at your cost.

Going back to the NHS and consultancies -- the irony is that the job could most likely be done in house but I expect the executive management have to call in consultancies , because producing the work in house would show that the management layers who could do it , were not already working to full capacity!! So, they get in consultants who dont necessarily have much expertise about how the system REALLY works (not the on paper version) , who go to middle and lower management to learn whats going on , and then package the in house information up in a more professional looking form, and sell it to the NHS at shedloads an hour. The costs for consultants were well over £500 a day even more than 10 years ago. Theyve always used consultants for all sorts at huge cost.

Does hiring a consultancy firm mean those at the top aren't doing the job they are being well paid for?.I do think those that do the hiring of one of those can pick and choose one that may do a report that may report very little wrong with how the hirer does their job.Firm believer that those that pay the piper pick the tune